LUPUS ERYTHEMATOSUS, SYSTEMIC (SLE)

General Information

DEFINITION--An inflammatory disease of connective tissue. Lupus is not inherited or cancerous.

BODY PARTS INVOLVED--Connective tissue (collagen). Many body systems are affected, including joints, skin, kidneys, brain, heart and lungs.

SEX OR AGE MOST AFFECTED--All ages and both sexes, but 90% of cases occur in women between ages 30 and 50.

SIGNS & SYMPTOMS--

Lupus symptoms frequently flare up and then subside. Episodes generally include fever and fatigue, plus any 4 of the following:

• Rash, usually on the cheeks.
• Ulcers in the mouth.
• Red palms and hands.
• Joint pain with redness, swelling and tenderness--but no deformity.
• Swelling of the face and legs.
• Shortness of breath; rapid or irregular heartbeat; chest pain; hair loss.
• Swelling of the lymph glands.
• Protein in the urine; anemia.
• Increased sensitivity to the sun.
• Mental changes, including psychosis.

CAUSES--Unknown, but lupus is probably an autoimmune disorder. In an autoimmune disorder, the body's immune system functions abnormally and attacks its own normal tissue.

RISK INCREASES WITH

• Stress.
• Use of drugs, such as hydralazine, procainamide, methyldopa and chlorpromazine.
• Genetic factors. The incidence is higher among blacks, Hispanics, Native Americans and Asians.

HOW TO PREVENT--Cannot be prevented at present.

What To Expect

DIAGNOSTIC MEASURES--

• Medical history and exam by a doctor.
• Patients with vague, recurrent symptoms may require long-term observation before a final diagnosis can be made. Laboratory studies of antinuclear antibodies, blood count and sedimentation rate aid in the diagnosis.

APPROPRIATE HEALTH CARE

• Self-care after diagnosis.
• Doctor's treatment.

POSSIBLE COMPLICATIONS

• Bacterial or viral pneumonia.
• Impaired kidney function.
• Pericarditis.
• Seizures.
• Hypertension.
• SLE is sometimes associated with other autoimmune disorders such as arthritis, diabetes, hypothyroidism.

PROBABLE OUTCOME--Lupus is currently considered incurable. The disease is characterized by remissions and relapses. The prognosis is variable depending on the organs involved and the extent of the inflammation. Symptoms can be relieved or controlled for many years. Medical literature cites instances of unexplained recovery.

How To Treat

GENERAL MEASURES--

• Obtain prompt medical treatment for any infection.
• Sunlight sensitivity may occur in some patients. If so, avoid exposure or use protection of hats, sunglasses, sunscreens, long sleeved clothing.
• Apply heat or ice to relieve joint pain.
• Control the stress in your life.
• Don't take any immunizations or drugs without consulting your doctor. Immunizations and some drugs may cause relapses or worsen current symptoms.
• Don't become pregnant without consulting your doctor. Pregnancy may overload the kidneys and cause death.

MEDICATION--Your doctor may prescribe immunosuppressive, steroid and nonsteroidal anti-inflammatory drugs or anti-malarial drugs. These relieve symptoms but don't cure the disease.

ACTIVITY--

• Remain as active as possible; however extra rest may be needed.
• Active exercises are encouraged to retain full range-of-motion. Physical therapy may be recommended.

DIET--If your kidneys or heart are affected, restrict your salt intake. Otherwise, no special diet is necessary.

Call Your Doctor If

• You have symptoms of systemic lupus erythematosus.
• Any of the following occurs after diagnosis: Fever of 101F (38.3C) or higher, blood in the urine, shortness of breath, chest pain, bloody stool, severe abdominal pain, any illness with fever.
• New, unexplained symptoms develop. Drugs used in treatment may produce side effects.